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NPI Code Detail

MEDICARE: PREFERRED PHYSICIANS PC

MEDICARE: PREFERRED PHYSICIANS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1821150798
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREFERRED PHYSICIANS PC
Provider Business Mailing Address
First Line : 430 W VOTAW ST
Second Line :
City : PORTLAND
State : IN
Zip : 47371-1302
Country : US
Telephone Number : 260-726-9027
Fax Number :
Provider Business Practice Location Address
First Line : 430 W VOTAW ST
Second Line :
City : PORTLAND
State : IN
Zip : 47371-1302
Country : US
Telephone Number : 260-726-9027
Fax Number :
Authorized Official
Title or Position : CEO
Name : STEPHEN R MYRON
Credential : MD
Telephone Number : 260-726-9027
Provider Enumeration Date : 12/15/2006
Last Update Date : 04/02/2008

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Directions to “PREFERRED PHYSICIANS PC ” Practice Location

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